In third-trimester bleeding, which statement is true?

• A. It always indicates infection
• B. It is painless
• C. Large volume of blood may be present, with compensatory mechanisms
• D. It is always accompanied by fetal movement slowing

Answer: (C)

In third-trimester bleeding, a major point is that a substantial amount of blood can be lost and the body may try to compensate. The mother’s heart rate can rise and blood vessels constrict to maintain blood pressure, so even large hemorrhages may not immediately crash vital signs. This makes the scenario dangerous because the bleeding can be heavy while the patient initially seems relatively stable.

Bleeding in late pregnancy can come from placental problems such as previa or abruption, and these don’t have to present with infection. It also isn’t universally painless—one cause can cause painful vaginal bleeding with uterine tenderness, while another can be painless. Fetal movement slowing is not a reliable, universal sign either. The key takeaway is that significant hemorrhage with compensatory physiology is a real possibility in the third trimester and requires urgent evaluation and management.